Drug Screen Request

If you are required to take a drug screen and you live outside the area, please use this form.  

Once you submit your information, you will be contacted by ARCpoint Labs and given instructions on how to complete a drug screen that will be accepted by your PTI Case Manager.

Your Name: *

Best Number to Contact You: *

Your Zip Code: *

Your Email Address *

Last 4 Digits of Your Social *

Date Test Is To Be Taken

Your PTI Case Manager's Name: *

Message (If Any)

Read Carefully! You will be contacted to schedule your appointment by ARCpoint Labs. You MUST bring your Registration Number on or before the scheduled test date in order to be tested. You MUST have a PICTURE ID with you. Indicate below that you agree. *

Yes - I Agree

No - I Do Not Agree

CAPTCHA (Enter the code from the image below):

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